Scarlet Fever: A Group A Streptococcal Infection – CDC Features

Scarlet Fever: A Group A Streptococcal Infection – CDC Features

Scarlet Fever: A Group A Streptococcal Infection

Doctor checking young girl's throatScarlet
fever results from group A strep infection. If your child has a
sore throat and rash, their doctor can test for strep. Quick
treatment with antibiotics can protect your child from possible
long-term health problems. 

Scarlet fever – or scarlatina – is a bacterial infection caused
by group A Streptococcus or “group A strep.” This illness
affects a small percentage of people who have strep throat or, less
commonly, streptococcal skin infections. Scarlet fever is treatable
with antibiotics and usually is a mild illness, but it needs to be
treated to prevent rare but serious long-term health problems.
Treatment with antibiotics also helps clear up symptoms faster and
reduces spread to other people.

Although anyone can get scarlet fever, it usually affects
children between 5 and 12 years of age. The classic symptom of the
disease is a certain type of red rash that feels rough, like

Scarlet Fever Podcast

A pediatrician explains the cause, treatment and prevention of
scarlet fever. Listen or download [5:09 minutes]

How Do You Get Scarlet Fever?

Group A strep bacteria can live in a person’s nose and throat.
The bacteria are spread through contact with droplets from an
infected person’s cough or sneeze. If you touch your mouth, nose,
or eyes after touching something that has these droplets on it, you
may become ill. If you drink from the same glass or eat from the
same plate as the sick person, you could also become ill. It is
possible to get scarlet fever from contact with sores from group A
strep skin infections.

Common Symptoms of Scarlet Fever

  • A very red, sore throat
  • A fever (101° F or above)
  • A red rash with a sandpaper feel
  • Bright red skin in underarm, elbow and groin creases
  • A whitish coating on the tongue or back of the throat
  • A “strawberry” tongue
  • Headache
  • Nausea or vomiting
  • Abdominal pain
  • Swollen glands
  • Body aches

Scarlet Fever: What to Expect

Illness usually begins with a fever and sore throat. There also
may be chills, vomiting, and abdominal pain. The tongue may have a
whitish coating and appear swollen. It may also have a
“strawberry”-like (red and bumpy) appearance. The throat and
tonsils may be very red and sore, and swallowing may be

One or two days after the illness begins, the
characteristic red rash
appears (although the rash can
appear before illness or up to 7 days later). Certain strep
bacteria produce a toxin (poison) which causes some people to break
out in the rash—the “scarlet” of scarlet fever. The rash may first
appear on the neck, underarm, and groin, then spread over the body.
Typically, the rash begins as small, flat red blotches which
gradually become fine bumps and feel like sandpaper.

Although the cheeks might have a flushed appearance, there may
be a pale area around the mouth. Underarm, elbow and groin skin
creases may become brighter red than the rest of the rash. These
are called Pastia’s lines. The scarlet fever rash generally fades
in about 7 days. As the rash fades, the skin may peel around the
finger tips, toes, and groin area. This peeling can last up to
several weeks.

Scarlet fever is treatable with antibiotics.
Since either viruses or other bacteria can also cause sore throats,
it’s important to ask the doctor about a strep test (a simple swab
of the throat) if your child complains of havin g a sore throat. If
the test is positive, meaning your child is infected with group A
strep bacteria, your child’s doctor will prescribe antibiotics to
avoid possible, although rare, long-term health problems, reduce
symptoms, and prevent further spread of the disease.

Boy washing hands with soap

It is important for anyone with a sore throat to wash his or her
hands often.

Long-term Health Problems from Scarlet Fever

Long-term health problems from scarlet fever may include:

  • Rheumatic fever (an inflammatory disease that can affect the
    heart, joints, skin, and brain)
  • Kidney disease (inflammation of the kidneys, called
    poststreptococcal glomerulonephritis)
  • Otitis media (ear infections)
  • Skin infections
  • Abscesses of the throat
  • Pneumonia (lung infection)
  • Arthritis (joint inflammation)

Preventing Infection: Wash Those Hands

The best way to keep from getting infected is to wash your hands
often and avoid sharing eating utensils, linens, towels or other
personal items. It is especially important for anyone with a sore
throat to wash his or her hands often. There is no vaccine to
prevent strep throat or scarlet fever. Children with scarlet fever
or strep throat should stay home from school or daycare for at
least 24 hours after starting antibiotics.

Antibiotics: Bacteria-Busters

Pharmacist holding antibioticsGroup A
Streptococcus, or group A strep, is a type of bacteria
commonly found in people’s throats and on their skin. Group A strep
can cause a range of infections, from a sore throat, called “strep
throat,” to skin infections, like impetigo. It also rarely can
cause extremely dangerous, life-threatening infections.

The word antibiotic comes from the Greek
anti meaning ‘against’ and bios meaning ‘life’ (a
bacterium is a life form). Antibiotics are also known as
antibacterials, and they are used to treat infections caused by
bacteria, such as scarlet fever or whooping cough.

target only bacteria
. They do not attack fungi or viruses,
which cause infections like athlete’s foot or the common cold. If
you or your child has an infection, it’s important to know the
cause and follow the right treatment. Improper use of antibiotics
has resulted in many bacteria becoming resistant to

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